Individual
KALLIE MARIE KRUGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
510 W MADISON AVE, NORFOLK, NE 68701-5231
(402) 371-9552
Mailing address
510 W MADISON AVE, NORFOLK, NE 68701-5231
(402) 371-9552
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6761
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026333400
—
NE
Enumeration date
06/04/2008
Last updated
12/10/2019
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